Has Democratization Reduced Infant Mortality in Sub-Saharan Africa?

picture by Teseum on flickr.

Masayuki Kudamatsu (2006)

Does democracy help babies survive in sub-Saharan Africa? By using retrospective fertility surveys conducted in 28 African countries, I compare the survival of infants born to the same mother before and after democratization to identify the eﬀect of democracy. In measuring democracy, I adopt a theoretically motivated deﬁnition of democracy: universal suﬀrage and contested elections for executive oﬃce. I ﬁnd that infant mortality falls by 1.8 percentage points, 18 percent of the sample mean, after democratization. The size of the reduction is larger for babies born to mothers from disadvantaged groups. I also ﬁnd that the replacement of a chief executive by democratization is the driving force behind these results. Additional evidence suggests that improvements in public health service delivery, not an increase in aﬄuence, are the key mechanism in which democratization has reduced infant mortality.